Exhibits
Client history has been collected, and the nurse performs a physical assessment and records vital signs.
Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.
Nonsmoker
Obesity
Drinks beer nightly
Daily aspirin
Type 2 diabetes mellitus
Sleep apnea
Ibuprofen for pain
Osteoarthritis
Correct Answer : B,C,E,F
A. Nonsmoker: Smoking does not directly contribute to the development of gout. While smoking is a risk factor for many health conditions, it is not a major contributor to the elevated uric acid levels associated with gout.
B. Obesity: Obesity is a well-established risk factor for gout because it leads to increased production of uric acid and reduced renal excretion of uric acid. Higher body fat increases the likelihood of developing hyperuricemia (elevated uric acid levels in the blood), which can form crystals in the joints, leading to gout.
C. Drinks beer nightly: Alcohol, particularly beer, is a significant risk factor for gout. Beer contains high levels of purines, which are broken down into uric acid in the body. Chronic alcohol consumption, especially beer, increases uric acid levels, contributing to the formation of uric acid crystals in the joints, which leads to gout attacks.
D. Daily aspirin: Aspirin, particularly at low doses, can reduce the excretion of uric acid by the kidneys, which can increase the risk of hyperuricemia and gout. However, this effect is typically observed with chronic, low-dose aspirin use, which is not indicated here in the patient's history.
E. Type 2 diabetes mellitus: Type 2 diabetes mellitus is associated with insulin resistance, which impairs the kidney's ability to excrete uric acid. As a result, uric acid builds up in the bloodstream, increasing the risk of gout. Additionally, people with type 2 diabetes often have comorbidities (such as obesity) that further increase the risk of gout.
F. Sleep apnea: Obstructive sleep apnea is associated with intermittent hypoxia (lack of oxygen), which can contribute to the production of uric acid and decreased renal clearance. This increase in uric acid levels raises the risk of hyperuricemia and subsequently gout. Sleep apnea can also be related to metabolic syndrome, which is another risk factor for gout.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"}}
Explanation
- Blood pressure 130/86 mm Hg
- Neither Disease Process Nor Medication: This blood pressure reading is within the normal range for an adult and does not indicate a specific disease process or medication effect.
- Temperature 98.9° F (37.1° C)
- Neither Disease Process Nor Medication: This temperature is within the normal range and does not indicate a specific disease process or medication effect.
- Oxygen saturation 88% on room air
- Disease Process: This low oxygen saturation level is likely due to the acute asthma attack, which is a disease process affecting the client's ability to oxygenate properly.
Correct Answer is A
Explanation
A. Tenderness upon palpation and generalized erythema indicate skin irritation and possible sunburn, which are signs of overexposure to PUVA treatment. This finding suggests that the client may have received excessive ultraviolet exposure, leading to skin damage.
B. Thick skin plaques topped by silvery white scales are characteristic of psoriasis vulgaris itself, not a sign of overexposure to PUVA.
C. Requiring sunglasses because sunlight hurts the eyes may indicate sensitivity but is not a specific indicator of overexposure to PUVA treatment; it could relate to other issues such as underlying eye conditions.
D. Brown, rough, greasy, wart-like papules on the face are not typically associated with PUVA overexposure but could be related to other skin conditions or lesions.
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